Archive for tag:
nutrition

I've been embroiled in a debate on different eating habits for a
few weeks. It's been a heated debate. Information has been passed
back and forth, but the science is a hard sell for those that don't
know or understand it. I say, science, because it's not just the
facts about Paleo, gluten-free, Mediterranean, or whatever eating
patterns/diets, but about nutrition in general. It's about how our
bodies handle food and what they need to be healthy.

There are a million and one (and probably more) "diets" out
there. Right now, Paleo and gluten-free seem to be trending the
most. Celebrities are using them to "get healthy." People are using
them for weight loss or to control the symptoms of one disease or
another. Some are using them to lower their inflammatory levels.
But few seem to know the actual science behind any of it.

Image source: www.towelmate.com

I'm admittedly biased. I've been a diagnosed Celiac, and gluten
free for 16 years. The more information that I learn about grains,
etc. -- the more I'm glad that I don't eat gluten. But the general
public doesn't have the information that I have. In fact, it seems
that most professionals don't either. But that's not the purpose of
this posting.

When I started out writing this, I thought about my friend and
how vehemently she adheres to her beliefs about "nutrition" and
eating. She's a registered dietician. We've argued back and forth
about grains, about how she thinks that Paleo/Mediterranean is bad
for athletes, about how impossible it is to follow, and about how
there's a lot of "false" science/claims about that particular
eating pattern. The whole experience has been a major illustration
on the adherence to beliefs that people have -- not just for her,
but for me. It's also been an exercise in frustration.

I can only "recommend" what science (and anecdotal evidence --
but that's another story) shows to be true. For example, I can
explain that zonulin destroys tight junctions in the gut, brain,
and reproductive organs, and that the main sources of tight
junction destroying proteins are grains and legumes. I can quote
studies all day long (and all night long) -- and I have. I can
distill the science down to very simple words that anyone could
understand by using pictures, analogies, and more broad terms. I
can do all of these things, but that doesn't mean it's going to
change anyone's mind, and it also doesn't mean that they're going
to be willing to put it into practice.

We're very steeped in our beliefs. Usually, those beliefs have
absolutely nothing to do with evidence. My friend, for example,
focuses on athletes and sports nutrition. The concept of
carb-loading with pasta or the use of sports drinks is very much a
part of her reality. She's concerned about having energy available
for use. She's not concerned about inflammation, overall health and
well-being, the prevention of disease, or whether or not someone
might develop cancer or an autoimmune disorder. She wants to run
marathons, or play 4-hour-long matches. Her reality and mine are
very, very different. Chances are, that no matter what I say or
provide her with, she will always adhere to her thoughts about
nutrition. It will always be about the quick fix. My hope is that
she'll come across a difficult case and be forced to broaden her
concept of what healthy eating is.

Patients aren't any different. Some may have more or less
information than my friend. They may be coming in with a copy of
some new fad diet book, or a cookbook of recipes that their Aunt
Sally said worked really great to help her lose weight. People may
walk into the office carrying a well-worn copy of the all-carrot
diet, asking what to do about their increasingly orange skin.
They'll be emphatic about drinking their diet coke, eating their
bowl of pasta, or consuming 3 Tablespoons of apple cider vinegar
before every meal.

Image source: msmomofosho.wordpress.com

It will be our job to walk them through their questions,
hopefully bring some experience and education to the table, and
talk them through ideas and possibilities that will help them find
some form of healthy, sustainable ground. They may resist with
everything that they have in them. As I write this, I'm thinking
about how much I struggle with sugar or eating rice, and how hard
it has been for me to give them up; I'm not there yet. It's our job
to work with them, using their limitations (even if those are
beliefs), and our education to help them get to someplace
healthier.

My friend and I will probably continue to argue about what we
should or shouldn't be eating. The only thing we've been able to
agree on so far, I think, is that there's no one single "right"
way. There's no perfect way that everyone should be eating. We're
all human, and each body is different. The science may figure out
that everything we "know" is wrong, and everything must be changed.
I may never be able to fully give up sugar or rice. But whatever
happens, we'll all hopefully be happier and healthier because of
what we learn -- about food, about our relationship with it, and
our relationships with each other.

Surely you've heard the phrase: "Eat to live, not live to eat."
It seems that our relationship with food is extremely complicated.
It turns out, it's not just our mindset right now, but also every
attitude that we've had about food from our childhood that affects
how, what and why we eat. Did you ever make cookies with your
grandmother, or have a special birthday dinner? Was there some
treat that you only had on special occasions? Did you go
trick-or-treating for Halloween? Unless we've somehow managed to
avoid all of those things, food has become a reward and measure of
comfort in our lives.

Of course, there's nothing wrong with this. But we have to be
aware of it. As we go through our lives running crazy, working
ourselves ridiculous hours, studying, going from obligation to
obligation, taking on way too much, it's really easy to seek
consolation in our food.

Of course, there's more to it than that. Eating these things
ignites reward chemistry in our brains. Dopamine is produced
leading to the sensation of pleasure. Serotonin, which most people
recognize as the hormone affecting depression, is dramatically
affected. In fact about 95% of the serotonin is produced in the
gut. This not only regulates how much food we eat, but how we feel
about how much food we eat. It has direct impact on our mood about
food.

There are other, seemingly less interesting, hormones involved
with food intake. Leptin, produced in adipose tissue, regulates
food intake and fat storage. Deficits or defects in it lead to
overeating. Another hormone, CCK, which is released from the small
intestine while you eat, provides negative feedback about the
quantity of food. Deficits in it (or damage to the small intestine)
lead to overeating. Ghrelin, insulin, cortisol, and glucagon are
also involved. *Whew!*

You see, we treat food as medicine, not just because of the
hormones it induces, but because of the nutrients it provides. We
can use food to medicate or nourish our bodies.

We need those nutrients to live. They provide the building
blocks of everything that we are, the chemicals that sustain us,
and the energy that keeps us going.

I've been doing some reading (in all my spare time) about the
psychology of eating. It turns out there's a whole Institute for
the Psychology of Eating. I've been exploring the ideas of why
people eat; how much food we really need to live; and how we can
nourish ourselves body/mind/spirit without overindulging. The topic
itself is absolutely fascinating, and challenging in ways beyond
all of the science.

It's food for thought.

Everybody have an amazing week!

For more information on the psychology of eating and hormonal
control of eating, check out:

This is one of those times when writing the blog is tough,
because I can't remember all of the things I've done over the last
week! I'm to the point where I'm keeping daily lists so things
don't fall through the cracks. There's just so much to do and so
much to study for.

Last week I had 2 exams, and this coming week, 2 exams and 2
quizzes. Next week (brace yourself), there are 5 exams. I've always
wondered why we do things this way. Five exams in one week are too
many. It's just as if it were finals. But, here we are.

I was able to join some of my classmates out on Friday night. It
seems that a good time was had by all. We were able to meet some of
the first trimester folks that I'd missed from the First Tri Mixer.
They all seem really great. One of the drawbacks to the way our
campus is set up here is that the students are spread out to four
different places. We have the basic science students in one
location, the clinical science students in another, and the interns
in two different clinic locations. So, once someone crosses over
into a different area, we don't always see each other again--unless
we make an effort to do so. So that's why the mixers and impromptu
get-togethers are really important. It gives us a chance to meet
some of the other students from different locations.

I like how cohesive our group is in particular. I've mentioned
this before, but we really do become somewhat of a family. After
all, we spend five days a week, together, ALL day. If we don't love
or hate each other by the end, there's something wrong. Those that
have joined our original four members have been welcome additions.
And of course we miss those that have left us--whether they
transferred campuses to Lombard, or decided to slow down. Most of
my original class is now in the same building. It's good to see
them every day again. I've missed them.

As if I didn't have enough going on, last week, I started the
Master's Degree in Human Nutrition and Functional Medicine through
the University of Western States. The program is all online and we
have students from literally all over the world. The program there
is a wonderful complement to the program here. Since my goal is to
have an integrative, functional medicine practice, it's a great fit
for me. My goal is to complete the master's about the same time I
finish here at National. I'll let you all know how that's
going.

Time management and prioritizing are absolutely key to
maintaining some semblance of sanity with all this coursework. I'm
not sure I'm there yet--but I'm working on it. Of course, anyone
that knows me knows that I'm at least partly insane, so I must have
lost something somewhere. Calendars, schedules, lists, planning,
and keeping track of everything that has to be done is extremely
important. On top of that, checking all of those things off the
list is extremely fulfilling. I have to remember to ONLY put things
on the list that HAVE to be done--no lofty ambitions, week-long
projects, or 5-year goals. My lists sometimes get out of
control--admittedly, and sometimes they end up with the weirdest,
most random thoughts written on them--like philosophical questions.
And THAT could go anywhere. :)

(Image source: redlandrambles.wordpress.com)

I took a few minutes out of studying on Saturday to go to a
ROOTS seed and plant share event. We grew a lot of our own food
when I was growing up, and as I've had space, have tried to do the
same off and on. Now that I have some yard space, I'm working on it
again. Let me just say that this event was absolutely amazing.

People from the local area bring seeds they've collected,
cuttings, plants, trees--you name it--and they just give it away. I
took some Aloe seeds that my plant had put out last year. I'd been
saving them for quite a while. I honestly didn't even know that
Aloe seeded; I'd only seen people plant Aloe by cutting. The Aloe
plant that produced the seed was gifted to me a few years ago from
a fellow student, so it only seemed fitting that I gift its
progeny. In return, I was gifted pumpkin seeds, stevia seeds,
loofah seeds, and heirloom squash seeds. I was hoping for loofah,
but couldn't believe how much was there!?! A lady tried to send me
home with a bag full of about 500 seeds! People were so generous.
I'm eternally grateful, and hopefully my garden will be booming
here in a couple of weeks. Since I've never had a fall garden
before, I have no idea what to expect. We shall see.

Well, you wouldn't know it by looking outside. We've had a few
really nice days, but it's expected to be in the 50s one day this
week. It's almost April! What is going on? I know everybody up in
the Midwest has had snow. I just keep looking out the door
bewildered and checking the Weather Channel on my phone. I never
know what it's going to be! Bundle-up or flip-flops, or my personal
favorite, blue toes in flip-flops? We just take it day by
day.

I thought for sure that I'd make it outside for something this
weekend, but it didn't happen. I did, however, make a cameo at the
Gluten Free Expo at the St. Petersburg Coliseum. Grey and I showed
up about an hour before it was over, wondering if they'd have some
great speaker at the last minute or some new revolutionary
products. There were, of course, TONS of giveaways and coupons and
brochures. I did grab a few business cards from vendors and talked
to a health coach while I was there.

I must say, though, that I was disappointed. While I'm grateful
that I now have free snack fodder for the boys' lunches for the
next month plus, I'm not sure how healthy it all is. There's just
so much processing going into gluten-free products these days.
Nothing they were giving away or selling was anywhere near simple
or resembling anything homemade.

I talked to a baker about Paleo cooking. She said that the
biggest problem for them was cutting out the sugar. She wanted to
substitute Stevia--which in some Paleo circles is forbidden (no
artificial sugars or regular sugars). Although I'm not sure what
other ingredients she was going to substitute, the sugar, I think,
was the least of their worries.

In Diet and Nutrition, Dr. S has been teaching us all the
pathways and extolling the dangers of grains, sugars, and
indirectly, processing. We've linked all these starches, Omega 6s,
and sugars to everything from heart disease to Alzheimer's. Of
course that doesn't make it all so easy to give up, but the
argument is getting more and more persuasive. So I have to
think--just because something is gluten-free, that doesn't make it
healthy. Whether it's the canola oil, the high fructose corn syrup,
or the ingredient that I can only dissect with a piece of paper and
a chemistry textbook, it may still be gluten-free, but it's also a
science/health experiment. I know for a fact, that gluten-free can
still be simple. The more ingredients, the more likely that there
might be a problem, and that doesn't work for anyone.

I'm beginning to explore the ins and outs of the Paleo diet and
trying to marry it with my own sense of nutrition. I suspect I'll
be more restrictive in many ways than what the standards are. I
still can't see/justify eating huge amounts of bacon. Something
just doesn't seem right about that. I'm not sure whether it's the
huge amounts of fat, the salt, or the nitrates. Yes, I know that
all of those are available nitrate-free, but last time I
checked--we were all students, yes?--I also know that I will never
eat beef or eggs again. I think there has got to be a way to
balance nutrition and our evolutionary developments with the limbic
system. Otherwise, we'll all end up eating only 35 cups of Romaine
lettuce with steaks wrapped in bacon. And between you and me, none
of that sounds all that appetizing.

Last but certainly not least, I want to congratulate everyone on
making it through midterms. We finally had our last one on
Thursday. I'll spare you all the drama involved, but I know we are
all extremely glad that that is over. I want to offer Dr. Ott my
undying gratitude for being, perhaps, the coolest-headed professor
I've ever come across. I must find for you, Dr, Ott, 5 million gold
toilet stickers. You deserve them. (And if you want to know the
story about the gold toilet stickers, you can email me).

Everyone also deserves congratulations for making it through
Mercury retrograde. Thankfully, Mercury went direct on St. Patty's
Day--and not a moment too soon. I was tired of fixing everything,
fighting and mediating fights, and just generally being in a
funk.

Happy First Full Week of Spring to everyone and Happy Easter,
Ostara and a Blessed Passover to all who celebrate.

This week's pictures are from Lake Maggiore--which is not far
from my house. I was hoping to get some gators in there, but it was
a bit too cloudy. If you enter through Boyd Hill and take the
trails, I PROMISE you'll see some BIG gators. To my classmate
Lauren, here's where you (don't) want to go. :)

On Easter, this year, while everybody's eating their dark
chocolate Paleo-friendly bunnies (I like to bite the ears off
first), I'll be celebrating 15 years of being gluten-free. It's
hard to believe. "Back in the day", things were a whole lot
different than they are now. It seemed that few people had celiac
(or were gluten-free) or knew anything about it--including the
professionals. The testing was different--biopsy and IgG
anti-gliadin or anti-endomysial blood tests. The pre-made food was
a lot harder to find (and surprisingly less expensive) and the
education of the medical community was nearly non-existent. My how
things have changed! There are sensitive and specific blood tests
now (tissue trans-glutaminase), everything seems to have a
gluten-free label on it, and docs--especially those in our
profession, seem to know more and more about the benefits of going
gluten-free.

My household has been gluten-free--exclusively--for the last 5
years. It's so important that the whole house be in support of the
diet. For me, it was a no-brainer. Both Grey and I are Celiac, and
Forest has never purposely had gluten. All the support groups
stress how important it is to avoid contamination (and NOT cheat!).
In order for a product to be considered gluten-free, it has to have
less than 200 ppm of gluten.

For Celiacs, even small/accidental exposures are dangerous.
People might not have an overt reaction to contamination amounts,
but they might still cause sub-clinical symptoms--flattened villi,
malabsorption, deficiencies, and constant damage to the
GALT--leading to lymphoma and GI cancers. Yikes, right?! These
small amounts can remain in cooking utensils, porous cooking pans,
and shared equipment. So, after a major move and shift within the
family, we started over with new utensils, new pots and pans, and a
completely clean house. Other than the occasional poison-carrying
visitor and the cats (whose food smell reminds me of wheat bread
toast), we don't even allow lickable envelopes (Did you know that
glue contains wheat?).

I can't begin to say how much of a difference going gluten-free
has made in my life. Besides feeling infinitely better, I've
experienced a number of benefits--from clearer thinking to better
skin and hair (and most importantly, a happier gut!). For Grey, the
benefits were a lot more dramatic. He was born at the
95th percentile, and before being diagnosed,
dropped to less than 5th percentile. Of course,
that was a long time ago--and now he's bigger than I am!

I've been asked if I'd endorse a gluten-free diet. I absolutely
would. I'm not so sure that I'd endorse all the pre-packaged foods
being sold on store shelves right now. Processing is pretty much
always bad. But, with all the research that's coming out about
lectins, gliadin, and grains, it's making more and more sense for
pretty much everyone to be gluten-free. So, I'll leave all of you
with this: Educate yourselves about what you CAN put into your
body--and what effects it might have. If you're not doing it for
yourselves, do so for your patients. Remember that not all cases
are textbook (in fact most cases of Celiac aren't). If you need
help, feel free to contact me. And for some other resources, check
these out: